Liquid Thyroxine: Can anyone help me please... - Thyroid UK

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Liquid Thyroxine

Odinil profile image
52 Replies

Can anyone help me please.

Because of my sensitivity taking levo tablets im now on liquid thyroxine.

Ive been on it for two months the brand is Teva lactose free. I am not lactose intolerant but thats what ive been given.

The palpatations have stopped but still have achey body. I have put on a stone in weight in 2 months only around my stomach area and midriff its so uncomfortable.

Teva liquid was recommended to me so i had it put on my prescription but because of the weight gain i would like to try another brand that might be better for me.

Any recommendations from anyone who is taking liquid thyroxine would be greatly appreciated.

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Odinil
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fuchsia-pink profile image
fuchsia-pink

I suspect your weight gain is more likely because you are not yet optimally medicated, rather than a liquid Teva issue. I for one cannot lose weight unless BOTH free T4 and free T3 are nice and high. Do you have any recent blood results you can share?

Odinil profile image
Odinil in reply to fuchsia-pink

My T4 is always top of range and T3 always low in range.Im about to have a blood test that i requested from my gp.

I didnt get the chance to speak to him just a message passed on thru receptionist so im guessing it wont include T3 testing.

I recently had a B12 Folate Ferritin blood test by gp. My B12 is low borderline but gp says its normal.

Im due to have a blood test next week at addensbrooke hospital they do test my T3 levels. My consultant at last visit said my tsh was too high and needed to come down and then maybe she would give me a small amount of T3.

I feel im up against a brick wall the whole time. Im going to see what happens when i speak to my consultant in a couple of weeks time when results will be in, if im still being fobbed off because thats how i feel i am going to see a private consultant as i feel thats the only way i am going to get to the truth regarding my meds.

When i get the gp and consultant's blood test results back i will put them on my post.

Thank you

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

All four vitamins need to be OPTIMAL

what vitamin supplements are you currently taking

Vitamin D at least around 80nmol and around 100nmol maybe better

Serum B12 at least over 500

Active B12 at least over 70

Folate and ferritin at least half way through range

What’s your diet like

Are you vegetarian or vegan,

gluten free or lactose free diet

All thyroid tests should be done as early as possible in morning before eating or drinking anything other than water and last dose levothyroxine 24 hours before test

How much liquid levothyroxine are you currently taking

Have you tried taking half dose waking and half dose at bedtime

Odinil profile image
Odinil in reply to SlowDragon

I take 65ml anything higher and i get more smyptoms just like the tablets.I havent tried taking it in two halfs thats an idea i may be able to up my dosage if thats whats needed. I always think the higher the dose the bigger the smyptoms. I'll never forget what my surgeon said pre op, we'll whip it out, pop a tablet each day and you'll be fine !!!!!

MichelleHarris profile image
MichelleHarris in reply to Odinil

65mls ?

I started 2 months ago too, on Teva, 50mcg in 5 mls, so taking 12.5mls.

Like you I put on 4 kgs in 4 weeks!

I then started strictly dieting and have lost one kg.

However I was apparently well over replaced on NDT (3 grains ThyroidS) but constipated every day ! That doesnt make sense to me.

On the liquid I’m not constipated at all but may have started a bit of tingling in my foot again.

I’m just going to give Teva liquid a bit longer to settle in my system.

I’m going to get a Medichecks test soon as well.

Its so hard to get right isnt it x

Odinil profile image
Odinil in reply to MichelleHarris

Its an absolute nightmare if you are not going through yourself its hard for people to understand. If you mention T4 and T3 and poor converter to non sufferers you can see you've lost them lol.I know Teva levo has a terrible reputation and i have always refused them. I was on Actavis and wockehart did ok on both but then Actavis became Accord and thats when all my problems started that was last September.

Im not sure about Teva liquid its the first brand ive tried so far, its lactose free although i am not lactose intolerant.

I do know that ive put on a stone in 2 months so im considering changing to another brand although the pharmacist says not too keep changing i cant help thinking thats because it seems the easiest and cheapest one they can get from the suppliers.

If its lactose free do they substitute it with something else who knows!!!!

Like sugar free has added sweeteners

MichelleHarris profile image
MichelleHarris in reply to Odinil

No I dont think it has anything added other than the hormone, water and glycerine (sickly sweet isnt it ? but apparently doesnt cause Diabetes according to my Endo) but helvella has a full ingredients list.

I have found it hard with Lactose and Gluten since starting on Levo two years ago. I didnt before. I think Levo somehow intereferes with absorption of Lactose and Gluten. Helvella has written a post on this phenomena. My throat swelled terribly and had a Sjogrens flare ( which I didnt know I had) and developed Oesinophillic Oesophagitis.

So I’m happy to be on Teva!

I take Low dose Naltrexone which helps massively!

I’m still trying to get right. I have friends swallow a Levo tablet for years and are absolutely great! I was a walking leader for years but since starting Thyroid replacement I cant walk too far. I’m having bloods done on NHS in Aug and going to get Medichecks at same time ( though I havent found Medichecks reliable).

Honestly so much for my trust in doctors looking after you - And my son has just qualified as one and regarding health matters but become as arrogant and dismissive as the rest 😞 x

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

Many, many people find it better to split levothyroxine dose into two doses …..waking and bedtime

Odinil profile image
Odinil in reply to SlowDragon

Thats interesting.I am on 65mg thyroxine liquid daily.

I have a syringe to measure dose so i can split it into two quite easily.

I was told by the gp to take 75mg liquid daily and not my usual dose of 62.5 mg tablet but i got

Palpartations, fluid retention all around my knees, blurry eyes although i still have blurry eyes on lower dose, tingling pins and needles in hands fingers and lower legs and aches and pains. All the symptoms as soon as i increase my dosage.

He just didnt listen when i told him that if i increase i get such awful symptoms, completed dismissed me.

The pharmacist told me i should reduce on liquid because it absorbs much more than tablets.

Its quite obvious that gp's see as nuisances not sufferers.

shaws profile image
shawsAdministrator

Request a Full Thyroid Function Test which is:-

TSH, T4, T3, Free T4, Free T3 and thyroid antibodies.

Book the earliest possible appointment. It is a fasting test but you can drink water and allow a gap of 24hours between your last dose and test and take it afterwards.

Also request B12, Vit D, iron, ferritin and folate.

Post results, with the ranges, onto a new post for comments.

p.s. If GP wont test all of the above, you can get a private test from one of the labs and ensure you are well-hydrated a couple of days before:-

thyroiduk.org/help-and-supp...

Odinil profile image
Odinil in reply to shaws

Blood tests being done go's and hospital. My B12 and folate are always borderline low but im told its normal. Tried supplementing but get pains pins and needles numbness in hands and lower arms plus blurred vision so stopped taking. Because b12 deficiency and levo can have simular symptoms its hard to know whether its the levo med or b12 supplements. Im at my wits end.

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

Down to you to self supplement vitamin levels to improve

NHS only tests and treats deficiencies

On levothyroxine we need OPTIMAL Vitamin levels

shaws profile image
shawsAdministrator in reply to Odinil

Do not supplement with B12 tablets unless you've already excluded Pernicious Anaemia.

P.A. is another autoimmune condition and if not diagnosed and given regular injections we can develop a serious illness.

Odinil profile image
Odinil in reply to shaws

I looked on Medicheck and its very expensive to have a PA blood test done. If its the only way im going to get the proof and hopefully the gp takes notice of a private result i will have to pay it. Ive been told they dont have to act on a private result. When i last mentioned a medicheck result to the gp she eye rolled and said your blood test result we done is fine. How the hell do you make them sit up and listen

shaws profile image
shawsAdministrator in reply to Odinil

If you live in the UK never mind your doctor's eyes rolling. Tell her as you've already got one (or two or more) autoimmune diseases, you've been advised to get a blood test to exclude that you do not have pernicious anaemia and to give you regular injections if you do have it.

Pernicious anaemia is common and my mother had it too. Unfortunately her GP stopped giving injections as my Mum was told 'your bloods are fine now' you don't need any more injections. My sister and I thought that was 'good advice' but it was awful advice as my mother, due to the GP stopping injections died of stomach cancer

You don't need to say who informed you as I now have five autoimmune conditions and all have to be looked after. Just as when, we're hypo, we cannot do without replacement hormones. We are looked after by the NHS.

There is also a pernicious anaemia site on Healthunlocked and am sure the members will be as helpful as those on this forum.

Thousands of people do not have the werewithal to have private doctors and private tests so that's why, in this country, we have the 'National Health Service' (NHS).

Odinil profile image
Odinil in reply to shaws

I am so sorry about your mum how awful, let down so badly

shaws profile image
shawsAdministrator in reply to Odinil

We always thought that doctors knew the basics of autoimmune diseases. That's not the case as I had to diagnose myself despite a TSH of 100 (I had never heard of hypothyroidism before or if someone mentioned it I would not have recognised it at all nor had it any meaning).

However, regarding my mother being already diagnosed as having P.A. injections shouldn't never be withdrawn.

Odinil profile image
Odinil in reply to shaws

So many people have told me that once you have B12 injections you have to have them for life. You cannot stop having them so if they know this and they are not doctors what chance do we have. Ive given up taking a gp's advice no matter what you say they go against it they dont always know best.

Odinil profile image
Odinil in reply to Odinil

I asked a locom at my previous surgery he agreed to have it done but it was refused at the lab

shaws profile image
shawsAdministrator in reply to Odinil

I have just put up a new post about P.A. that I posted in the past.

Hedgeree profile image
Hedgeree in reply to Odinil

Hi Odinil,

As Shaws says I think it could be helpful for you to post on the pernicious anaemia forum on Healthunlocked.

The sensations of pins and needles, numbness and the pain you describe when you supplement B12 can be part of the healing process as nerves reawaken and start to work again. I have read posts where other forum members have mentioned having a similar experience to yourself when they've supplemented B12.

The members on the PA forum will be able to advise you and are again a very friendly and helpful forum.

Best wishes.

Odinil profile image
Odinil in reply to Hedgeree

Thank you i joined the forum i will post on there and ask

SlowDragon profile image
SlowDragonAdministrator

Are you vegetarian or vegan

What vitamin supplements are you currently taking

Odinil profile image
Odinil in reply to SlowDragon

I do eat chicken and fish so not vegan.I started with B12 better you drops but stopped and started Igennus super B-Complex one tablet not two. I didnt feel good so i stopped and started on nature provides Bioactive B12 drops i had to stop those too as the aches and pains in my hands and lower arms was so painful. I had tingling pins and needles too. I felt so tired if i need B12 i cant understand why B12 supplements make me feel so horrible.

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

Well you need GOOD vitamins to be able to utilise thyroid hormones

If you’re not taking enough high enough dose levothyroxine…..then you’re going to get increased symptoms

To some extent you need to grit your teeth, start supplements and it should improve after 6-8 weeks

Odinil profile image
Odinil in reply to SlowDragon

Should i increase my levo dose as well as taking the supplements. I actually get worst smyptoms the higher the dose.I dont think i will be able to cope with the awful effects from both.

McPammy profile image
McPammy

Sounds like you are a poor converter of Levothyroxine T4 to active T3. I was prescribed liquid Levothyroxine also on a similar basis to yourself. I put on 2st very quickly. The liquid Levothyroxine didn’t make any difference to me. What really helped me was the introduction of T3 Liothyronine medication which I had to get a 3 month trial on privately. It was a huge success for me. My T4 level was at the top of the range but my T3 level was at the bottom. I was only converting 8% to T3. I also did the DIO2 gene test through Regenerus Laboratories which came back positive. This proved I am a poor converter. I took the result to my GP who scanned the report onto my NHS file. I now get T3 Liothyronine on the NHS. I truly feel brilliant now after struggling for 11 years previously just on Levothyroxine. I still take liquid Levothyroxine and I use the brand Wockhardt. I have also used Ten Pharma brand. Both suit me quite well. I was only put on liquid Levothyroxine to rule out any excipients issues but I believe it made no difference as it was T3 medication I really needed.

Odinil profile image
Odinil in reply to McPammy

Hi I'll look up D102 test. My consultant is going to call me on the 22nd July im hoping she will trial me on a small amount of T3 as she mentioned it at my last appointment under her breath but only if my tsh has gone down as i need to be suppressed because of the cancer which she said means putting my dosage up but if i do i get heart palpartations worst blurred vision aches pains etc.

By then i will have blood test results from the gp and the hospital.

Not holding out much luck.

I tried taking B12 supplements but i felt so ill the pain and tingling in my hands and lower arms were awful. Its my blurred vision that upsets me the most. I asked the gp to let me have a PA blood test but was refused. Gps consultants all deny that my T4 and T3 is not where it should be and my B12 and folate are normal even though im borderline low in range. Ive tried countless pharmacists trying to get a brand of liquid thyroxine that better suits me but all i get is we give you whatever comes in from the suppliers i say even if its on my prescription yes they say we dont have to order the brand on the prescription anymore its whatsever the cheapest. I ask for Wockehart and told its unavailable or they dont do liquid.

If i still get no joy on the 22nd im going to see (name removed by admin)

shaws profile image
shawsAdministrator in reply to Odinil

Your body may like injections better than tablets. If we have P.A. it has to be given by injections as our stomach cannot absorb B12.

shaws profile image
shawsAdministrator in reply to McPammy

'They' stopped prescribing liothyronine (T3) due to the exorbitant cost but I'm sure if they tried they could source it elsewhere - far cheaper than the NHS pays for it.

Odinil profile image
Odinil in reply to shaws

When i last saw my consultant in december i complained how unfair it was that T3 was not available on the nhs to patients that really needed it, she replied well i think thats going to change soon, i said, really when? She just smiled, didn't comment.

Odinil profile image
Odinil

Is it ok to take T3 solely, no T4?

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

Many people need addition of small doses of T3 prescribed alongside levothyroxine

But important to get all four vitamins optimal first

Very few do well/need T3 only

First step is to try small doses of T3 prescribed, typically 5mcg 3 times a day

Odinil profile image
Odinil in reply to SlowDragon

I just dont know how to get them optimal. I feel terrible when i take B12 supplements.Do i need to persevere so difficult when trying to hold my job down. Im struggling.

shaws profile image
shawsAdministrator in reply to Odinil

As you feel terrible when you take B12 tablets, you might need injections instead if your B12 is low.

Your stomach may have made some changes so that it no longer can absorb B12. Ask GP to check the 'intrinsic factor ' which will show whether you have - or don't have - pernicious anaemia diagnosed through a blood test.

Odinil profile image
Odinil in reply to shaws

I will ask. Is that less expensive for the nhs as i was refused a PA blood test im guessing because of the cost.

shaws profile image
shawsAdministrator in reply to Odinil

I had severe palpitations on levothyroxine (T4) but they resolved when T3 was added to T4 and shortly thereafter I went onto T3 alone and feel well and am symptom-free.

Odinil profile image
Odinil in reply to shaws

So can the body function without T4?If T3 was as cheap as T4 would everyone just be given T3 no T4?

Odinil profile image
Odinil

I will look the test up thank you.Gp's and nhs consultants have been told they cannot prescribe T3 on the nhs. They have all told me this.

So even though they know you need it they wont prescribe it.

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

Many of us do get T3 on nhs, but frequently need to get trial via private consultation and prescription initially

Which CCG area are you in

56,487 prescriptions in last year

Typically 6 prescriptions per person per year

openprescribing.net/analyse...

Odinil profile image
Odinil in reply to SlowDragon

My nhs consultant said she would give me a private prescription for T3 so she must think i need it. I didnt further it because i dont think i will be able to fund it myself. Im going to see what she says on the 22nd of this month im hoping she will give me some T3 she mentioned it at last appointment but only if my tsh has gone down. She sent me for a Nurologhy test because i was complaining of pins and needles and numbness in my fingers hands lower arms and legs.

Im about to have a 24 hour heart monitor fitted because of the palpatations and breathlessness.

The palpatations have stopped now i am on liquid levo and the tingling and numbness but i still dont feel well and horrible weight all around my stomach.

Maybe my consultant is ruling out any conditions that may not be connected to T4 hopefully this will prove that it is T4 causing it. I live in the borough of Waltham Forest London.

Odinil profile image
Odinil in reply to SlowDragon

Is T3 the same as T4 as in different brands. I have a difficult time trying to get the same brand every time i pick my T4 prescription up. They always seem to want to push Teva brand. I was told by a pharmacist that they dont have to take notice of whats on the prescription now as far as a brand is concerned they can give you whatever their supplier sends them, the cheapest!! If im lucky enough to be given T3 will i have the same problem?

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

There’s only 3 NHS brands

Typically dose is 5mcg 2 or 3 times a day. Usually with 20mcg tablets cut into 1/4’s as so much cheaper

20mcg - Teva, Morningside, Mercury Pharma

Price to NHS £101 for 28 tablets

10mcg and 5mcg tablets are Morningside only

Price to NHS

10mcg £148 per 28 tablets

5mcg £90 per 28 tablets

Private prescription enables access to Thybon Henning 20mcg tablets via specialist pharmacies in U.K. at £1 per tablet

Odinil profile image
Odinil in reply to SlowDragon

Are the nhs brands as good as the private prescription Thybon Henning brand?So if people are lucky enough to get T3 prescribed on the nhs do they do well on nhs brands?

Does it make any difference to the quality if you fund it yourself?

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

I get My T3 on NHS

I have helpful pharmacy who always get Morningside T3 for me

Many people say Thybon Henning is better/smoother…..but I haven’t tried it myself

Odinil profile image
Odinil in reply to SlowDragon

Thank you ive made a note of that. Very helpful

Odinil profile image
Odinil in reply to SlowDragon

So my gp wont prescribe Thybon Henning on the nhs.Is the only way to get this brand is to fund it myself?

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

Correct

Thybon Henning is unlicensed in U.K. via NHS

NHS pays vastly over the price for unlicensed medications…known as “specials”

Thybon Henning via NHS would be at least double cost of licensed T3

dailymail.co.uk/news/fb-534...

dailymail.co.uk/news/articl...

Odinil profile image
Odinil in reply to SlowDragon

So Thybon Henning T3 is licensed and available on nhs?

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

No Thybon Henning is UN licensed in U.K. on NHS but available on private prescription

Only 3 U.K. licensed suppliers via nhs

Mercury Pharma

Teva

Morningside

SlowDragon profile image
SlowDragonAdministrator in reply to Odinil

Waltham Forest is part of North East London CCG

1192 prescriptions for T3 in last year

openprescribing.net/analyse...

Odinil profile image
Odinil

I will check to see if any of my blood tests at the hospital have included a Adrenal test

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